压力控制通气和容量控制通气对全麻机械通气患者气管导管套囊压影响的比较：一项平行随机临床试验。

Comparison of the effect of pressure control and volume control ventilation on endotracheal tube cuff pressure in patients undergoing general anesthesia and mechanical ventilation: a parallel randomized clinical trial.

机构信息

Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran.

Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran.

出版信息

BMC Anesthesiol. 2023 Sep 5;23(1):300. doi: 10.1186/s12871-023-02263-1.

DOI:10.1186/s12871-023-02263-1

PMID:37670235

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10478180/

Abstract

BACKGROUND

Endotracheal intubation and mechanical ventilation are prevalent interventions in the operating room and intensive care unit. Recently, the complications of endotracheal tube cuff pressure have been a topic of interest. Therefore, this study compared the effect of pressure control and volume control ventilation modes on the endotracheal cuff pressure rate in patients undergoing general anesthesia and mechanical ventilation.

METHODS

In this triple-blinded randomized clinical trial, 50 patients undergoing open limb surgery and inguinal hernia were allocated to two groups of 25 based on inclusion criteria. After intubation, one group underwent ventilation on the pressure control ventilation mode, and the other underwent ventilation on the volume control ventilation mode. In both groups, using a manometer, the cuff's pressure was first adjusted in the range of 25-30 cm of water. Then, the cuff pressure was measured at 10, 20, and 30 min intervals. The data were statistically analyzed using independent t-test, and two-way repeated measures ANOVA.

RESULTS

The present study's findings showed that cuff pressure has significantly decreased over time in both study groups (F = 117.7, P < 0.001). However, a repeated measures ANOVA with a Greenhouse-Geisser correction showed no interaction between time and groups (F = 0.019, P = 0.98). The two groups had no significant difference in cuff pressure (F = 0.56, P = 0.458).

CONCLUSION

Since the cuff pressure has been significantly reduced in both groups over time, continuous monitoring of endotracheal tube cuff pressure in patients undergoing mechanical ventilation is essential. Therefore, it is suggested to keep the cuff pressure within the recommended range to prevent complications resulting from cuff pressure reduction, such as aspiration and ventilation decrease.

TRIAL REGISTRATION

The study was registered in the Iranian Registry of Clinical Trial on 23/02/2019 (trial registration number: IRCT20181018041376N1).

摘要

背景

气管插管和机械通气是手术室和重症监护病房中常见的干预措施。最近，气管插管套囊压力的并发症一直是研究的热点。因此，本研究比较了压力控制和容量控制通气模式对全身麻醉和机械通气患者气管插管套囊压力率的影响。

方法

在这项三盲随机临床试验中，根据纳入标准将 50 例行开放肢体手术和腹股沟疝的患者分为两组，每组 25 例。插管后，一组患者接受压力控制通气模式通气，另一组患者接受容量控制通气模式通气。两组均使用压力计将套囊压力调整至 25-30cmH2O 范围内。然后，每隔 10、20 和 30 分钟测量套囊压力。使用独立 t 检验和双向重复测量方差分析对数据进行统计学分析。